It is known that there exist various bioptic techniques based on the principle of a single-channel needle with aspiration means and/or cutting means, including a trocar or not, to take tissue specimens from animal and human organs. Furthermore, multi-lumen cannulae and needles are known (DE-C - 818 246 and DE-A 2 643 594), which, however, are not suited to take a biopsy and to apply a substance in one operating cycle.
With regard to aspiration biopsy, it is to be noted: The best known aspiration biopsy technique is based on the principle indicated by Menghini (Menghini, G. 1957: Un effettivo progresso nella tecnica della puntura biopsia del fegato. Rass. Fisiopat. clin. Ter. 29, 756). There a hollow needle having an average diameter of 1.4 mm and having a facility for attachment of a syringe is used, by which a negative pressure (suction) is applied upon piercing through the skin and prior to the organ puncture proper. The organ puncture (liver) then is realized with a sustained suction within a second.
With regard to excision biopsy, it is to be noted: Excision biopsy, in principle, is carried out by means of a cannula adequately ground on its front end. The excision means and the lumen of the cannula, during the puncturing procedure, are protected by a stiletto inserted in the lumen of the cannula, which is removed after puncture. It is only then that a cylindrical tissue piece is excised from the punctured organ under suction at a rotating forward movement (e.g., Tru-Cut Needle, Travenol).
With all the bioptic techniques presently in use, complications will have to be taken into account, depending on the type of puncture (as well as the organ to be punctured and on the technique applied) and on the general condition of the patient. The main complications with aspiration biopsy of the liver primarily involve profuse bleeding, bilious peritonitis and pneumothorax (Lindner, H. 1967: Grenzen und Gefahren der perkutanen Leberbiopsie mit der Menghini-Nadel. Dtsch. med. Wschr. 39, 1751; Piccinino F., Sagnelli E., Pasquale G., Guisti G., 1986: Complications following percutaneous liver biopsy. J. Hepatology 2, 165).
Excision biopsies from the lung tissue exhibit a relatively high complication rate due to hemorrhagic incidents and pneumothorax (McEvoy R. D., Begley M. D., Antic R. 1983: Percutaneous Biopsy of Intrapulmonary Mass Lesions. Cancer 51, 2321). Also with kidney biopsies and biopsies of other organs, perfuse bleeding is considered the most important complication.
In order to obviate these complications, it was recommended to subsequently plug the needle track with resorbable material so as to eliminate, in particular, bleeding complications (Riley S. A., Irving H. C., Axon A. T. R., Ellis W. R., Lintott D. J., Losowsky M. S., 1984: Percutaneous Liver Biopsy with Plugging the Needle Track: A Safe Method for Use in Patients with Impaired Coagulation. Lancet, Aug. 25, 1984, 436). Such techniques, however, imply a long residence time of the puncture needle in the organ, which again constitutes a cause of complications, in particular with liver punctures (Thaler H., 1982: Leberbiopsie. Springer-Verlag, Heidelberg - New York).
From Austrian Pat. No. 384,165, a biopsy device of the initially defined kind is known, with which the cannula has a curved partition wall towards the internal limitation of the cannula lumina. Therein, the partition wall does not reach immediately to the front end of the cannula so that the biopsy channel and the application channel communicate in the region of the tip of the cannula. The multi-lumen biopsy device according to Austrian Pat. No. 384,165 enables the collection of tissue and the application of substances plugging the puncture track in coordination with the puncturing procedure in one operating cycle, thus largely shortening the time of intervention.